CN211723286U - Intervention type remote locking and cutting device - Google Patents
Intervention type remote locking and cutting device Download PDFInfo
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- CN211723286U CN211723286U CN201921077796.5U CN201921077796U CN211723286U CN 211723286 U CN211723286 U CN 211723286U CN 201921077796 U CN201921077796 U CN 201921077796U CN 211723286 U CN211723286 U CN 211723286U
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Abstract
The utility model provides an intervention formula long-range knot and tangent line device for the knot of stylolite and lock nail, intervention formula long-range knot and tangent line device include the cartridge assembly, and the distal end of cartridge assembly is equipped with the space that is used for placing the lock nail, the lock nail is equipped with the threading chamber along the axial, and intervention formula long-range knot and tangent line device cartridge assembly offer the threading passageway along the axial, and the threading chamber and the threading passageway of lock nail are worn to locate by the stylolite, be equipped with the tangent line spare that an at least orientation threading passageway set up in the cartridge assembly, the cartridge assembly extrusion the lock nail makes the lock nail warp with fixed stylolite, tangent line spare cutting stylolite. In the use process of the intervention type remote locking knot and thread cutting device, the suture thread is always accommodated in the threading channel, so that the suture thread is prevented from tearing the puncture hole; and the locking efficiency is improved, the cutting line does not contact the tissues near the puncture, and the safety of the intervention type remote locking and cutting device is improved.
Description
Technical Field
The utility model relates to the technical field of medical equipment, especially, relate to an intervention formula remote locking knot and tangent line device.
Background
The operation of knotting and fixing suture is often required in the operation, and the traditional surgical operation is operated under the condition of open vision, and the knotting is usually carried out manually by a doctor. However, with the advance of technology, various minimally invasive and interventional procedures, such as laparoscopic procedures, transcatheter interventional procedures, etc., are becoming more common, which require a small operating window to be cut in the patient's body, whereby an instrument, such as an endoscope or interventional catheter, is inserted into the patient's body to a predetermined site for treatment. In such procedures, if knotting or securing of the suture in the patient is required, the operator is usually required to remotely manipulate the suture outside the patient through a small manipulation window to knot the suture in the patient.
Prior art suture locking devices typically employ surgical robots, knot pushers, or transcatheter suture locking implant systems to remotely knot or secure the suture. In the prior art, the knotted suture is cut by pressing a blade arranged on the ejector rod against a flat surface at the bottom of the chuck. However, this suture severing approach is more difficult to grasp the amount of blade to cartridge compression with the flat surface. If the extrusion amount is insufficient, there is a risk that the wire cannot be completely cut; if the extrusion amount is too large, the cutting edge of the distal end of the blade can be broken, and the patient can be seriously endangered.
SUMMERY OF THE UTILITY MODEL
The to-be-solved technical problem of the utility model lies in, to prior art's defect, provide one kind and can effectively guarantee that the stylolite is cut off intervenes long-range knot of locking and tangent line device.
In order to solve the technical problem, the utility model provides an intervention formula remote lock knot and tangent line device at first for the lock knot of stylolite and lock nail, intervention formula remote lock knot and tangent line device includes the cartridge spare, the distal end of cartridge spare is equipped with and is used for placing the space of lock nail, the lock nail is equipped with the threading chamber along the axial, the threading passageway is seted up along the axial to the cartridge spare of intervention formula remote lock knot and tangent line device, the stylolite is worn to locate the threading chamber of lock nail reaches the threading passageway, be equipped with an at least orientation in the cartridge spare the tangent line piece of threading passageway, the cartridge spare extrusion the lock nail makes the lock nail warp with fixed stylolite, tangent line piece cutting the stylolite.
The utility model provides a long-range knot of intervention formula and tangent line device, when using, threading chamber and threading passageway are passed to the near-end of stylolite, and at the fixed in-process of lock pin and stylolite, the tangent line spare cutting of tangent line structure the stylolite of lock pin near-end. When the intervention type remote locking knot and thread cutting device is used, the suture is always contained in the threading channel, so that an included angle cannot be formed between the suture and the conveying system when the suture is tensioned, and the suture is prevented from tearing the puncture; in addition, the thread cutting structure is arranged inside the intervention type remote locking knot and the thread cutting device, so that the working efficiency of the intervention type remote locking knot and the thread cutting device is improved, the thread cutting piece is not in contact with tissues near the puncture hole, and the safety of the intervention type remote locking knot and the thread cutting device is improved.
Drawings
In order to more clearly illustrate the technical solutions of the embodiments of the present invention, the drawings needed to be used in the embodiments will be briefly described below, and it is obvious that the drawings in the following description are some embodiments of the present invention, and it is obvious for those skilled in the art to obtain other drawings without creative efforts.
Fig. 1 is a schematic perspective view of an intrusive remote locking and cutting device according to a first embodiment of the present invention.
Fig. 2 is a sectional view taken along line II-II in fig. 1.
Fig. 3 is an enlarged view of the portion III in fig. 2.
Fig. 4 is a schematic perspective view of a locking nail extruded by a chuck assembly of an intrusive remote locking and cutting device according to a first embodiment of the present invention.
Fig. 5 is a cross-sectional view of the locking pin of fig. 4.
Fig. 6 is a schematic perspective view of a chuck assembly of the intervention remote keying and thread cutting device of fig. 2.
Figure 7 is an exploded perspective view of the cartridge assembly of figure 6.
Fig. 8 is a perspective view of another perspective of the first collet of the collet assembly of fig. 7.
Fig. 9 is a side schematic view of the first collet of fig. 8.
Fig. 10 is a perspective view of another perspective view of the second collet of the collet assembly of fig. 7.
Fig. 11 is a side view of the second collet of fig. 10.
Figure 12 is a perspective view of the cartridge assembly of figure 6 from another perspective.
Fig. 13-14 are schematic diagrams of the first embodiment of the present invention showing two different states of the chuck assembly of the intervention remote locking and thread cutting device.
Fig. 15 is a perspective view of the driving assembly of the intrusive remote locking and cutting device of fig. 3.
Fig. 16 is an exploded perspective view of the drive assembly of fig. 15.
Fig. 17 is a perspective view of the ejector pin member of the drive assembly of fig. 15.
Fig. 18 is a cross-sectional view of the pin member of fig. 17.
Fig. 19 is a cross-sectional view of the screw of fig. 18.
Fig. 20 is a cross-sectional view of the connecting rod pin of fig. 16.
Fig. 21 is a sectional view taken along line XXI-XXI in fig. 15.
Fig. 22 is a schematic perspective view of a pushing assembly of the intervention remote locking and thread cutting device in fig. 3.
Fig. 23 is an exploded perspective view of the pusher assembly of fig. 22.
Figure 24 is a cross-sectional view of the thrust tube of figure 22.
Figure 25 is a side view of the front end outer tube of the pusher assembly of figure 23.
Fig. 26 is a cross-sectional view of the leading end outer tube of fig. 25.
Fig. 27 is a perspective view of an alternate perspective of the end cap of the pusher assembly of fig. 23.
Fig. 28 is a cross-sectional view of the end cap of fig. 27.
FIG. 29 is a cross-sectional view taken along line X X IX-X X IX in FIG. 22.
Fig. 30 is a partial sectional view of the chuck assembly, the driving assembly and the pushing assembly of the intrusive remote locking and cutting device according to the first embodiment of the present invention after assembly.
Fig. 31-33 are schematic views of the intervention remote locking and cutting device according to the first embodiment of the present invention for valve repair of a diseased mitral valve.
Fig. 34-35 are schematic views illustrating a process of the intervention type remote locking and cutting device for fixing a suture thread to a locking nail according to the first embodiment of the present invention.
Fig. 36 is an enlarged view of the portion X V I in fig. 33.
Fig. 37 is a schematic structural diagram of a chuck assembly of an intrusive remote locking and cutting device according to a second embodiment of the present invention.
Fig. 38 is a schematic structural view of a chuck assembly of an intrusive remote locking and wire cutting device according to a third embodiment of the present invention.
Fig. 39 is a schematic structural diagram of a chuck assembly of an intrusive remote locking and cutting device according to a fourth embodiment of the present invention.
Fig. 40 is a schematic structural diagram of an intrusive remote locking and wire cutting device according to a fifth embodiment of the present invention.
Fig. 41 is a perspective view of a first collet of the collet assembly of the interventional remote keying and thread cutting device of fig. 40.
FIG. 42 is a perspective view of the spindle of the chuck assembly of the interventional remote hitch and thread cutting device of FIG. 40.
Fig. 43-44 are schematic views illustrating a process of the intervention type remote locking and thread cutting device for fixing a suture thread to a locking nail according to a fifth embodiment of the present invention.
Fig. 45 is a schematic structural view of an intrusive remote locking and wire cutting device according to a sixth embodiment of the present invention.
FIG. 46 is a perspective view of a screw of a drive assembly of the intrusive remote hitch and tangent device of FIG. 45.
Fig. 47 is a cross-sectional view of the screw of fig. 46.
Fig. 48 is a perspective view of the top bar of the driving assembly of the intrusive remote hitch and tangent device of fig. 45.
Fig. 49-50 are schematic views illustrating a process of the intervention type remote locking and cutting device for fixing a suture thread to a locking nail according to a sixth embodiment of the present invention.
Detailed Description
The technical solutions in the embodiments of the present invention will be described clearly and completely with reference to the accompanying drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only some embodiments of the present invention, not all embodiments. Based on the embodiments of the present invention, all other embodiments obtained by a person of ordinary skill in the art without any creative effort belong to the protection scope of the present invention.
Furthermore, the following description of the various embodiments refers to the accompanying drawings, which are included to illustrate specific embodiments in which the invention may be practiced. Directional phrases used in this disclosure, such as "upper," "lower," "front," "rear," "left," "right," "inner," "outer," "side," and the like, refer only to the orientation of the attached drawing figures and, thus, are used in a better and clearer sense to describe and understand the present invention rather than to indicate or imply that the device or element so referred to must have a particular orientation, be constructed and operated in a particular orientation, and thus should not be considered limiting of the invention.
Orientation definition: for clarity of description, the end of the surgical procedure that is closer to the operator will be referred to hereinafter as the "proximal end" and the end that is further from the operator will be referred to hereinafter as the "distal end"; the axial direction is parallel to the direction of the connection line of the center of the far end and the center of the near end of the medical instrument; the foregoing definitions are for convenience only and are not to be construed as limiting the present invention.
Referring to fig. 1 to 3, the present invention provides an insertion type remote locking and thread cutting device 100 for locking a suture thread and a locking nail 300, wherein the insertion type remote locking and thread cutting device 100 comprises a collet assembly 20, a driving assembly 40 disposed at a proximal end of the collet assembly 20, a pushing assembly 60 sleeved outside the collet assembly 20 and the driving assembly 40, and at least one suture thread cutting element 29 disposed in the collet assembly 20. The far end of the clamping head component 20 is provided with a gap 25 for placing the locking nail 300, the locking nail 300 is provided with a threading cavity 301 along the axial direction, the intervention type remote locking and thread cutting device 100 is provided with a threading channel 26 passing through the clamping head component 20 and the driving component 40 along the axial direction, and the suture thread passes through the threading cavity 301 of the locking nail 300 and the threading channel 26. The driving member 40 rotates relative to the pushing member 60 to push the collet assembly 20, so as to press the locking nail 300 placed in the gap 25, so that the locking nail 300 is deformed to fix the suture, and at least one of the cutting members cuts the suture during the process that the collet assembly 20 presses the locking nail 300. Because the suture is always accommodated in the threading channel 26 in the using process of the intervention type remote locking and cutting device 100, when the suture is tensioned, an included angle is not formed between the suture and a conveying system, and the suture is prevented from tearing a puncture; in addition, since the thread cutting element 29 is disposed inside the intervention type remote locking and thread cutting device 100, and the thread cutting element 29 cuts the suture thread in the locking process of the locking nail 300 and the suture thread, the working efficiency of the intervention type remote locking and thread cutting device 100 is improved, the thread cutting element 29 does not contact the tissue near the puncture, and the safety of the intervention type remote locking and thread cutting device 100 is improved.
The interventional remote knot and thread cutting device 100 further includes a handle 80 connected to the proximal end of the drive assembly 40 and the proximal end of the pusher assembly 60. The handle 80 comprises a fixed portion 82 at the distal end and a movable portion 84 at the proximal end, the movable portion 84 is rotatable relative to the fixed portion 82, the fixed portion 82 is fixedly connected to the proximal end of the pushing assembly 60, the movable portion 84 is connected to the proximal end of the driving assembly 40, and the driving assembly 40 is driven to move axially relative to the pushing assembly 60 by relative movement between the movable portion 84 and the fixed portion 82. Specifically, the movable portion 84 and the fixed portion 82 are relatively rotatable and axially movable to drive the driving assembly 40 to rotate and axially move relative to the pushing assembly 60, and when the driving assembly 40 pushes against the chuck assembly 20, the locking nail 300 disposed in the gap 25 can be pressed to complete the fixation of the suture to the locking nail 300, and during this process, the cutting member 29 cuts the suture at the proximal end of the locking nail 300.
As shown in fig. 3-5, threading lumens 301 of the locking nail 300 extend axially through opposite ends of the locking nail 300 for receiving and passing sutures. The locking pin 300 may be collapsed when subjected to mechanical forces to secure the suture in the threading lumen 301. The locking pin 300 may be of various shapes, e.g., cylindrical, prismatic, oval, etc., so long as it has a threaded cavity 301 for receiving a suture. In this embodiment, the locking pin 300 is formed in a hollow cylindrical shape to reduce the resistance to pressure and to prevent scratching of human tissue. The outer wall of the distal end of the locking nail 300 is provided with an annular truncated cone 303 in a protruding mode in the radial direction. The distal opening of the threading lumen 301 of the locking nail 300 smoothly transitions with the distal surface of the locking nail 300 to avoid the junction therebetween cutting the suture or scratching the internal tissue of the patient. Specifically, an arc-shaped transition surface 305 is provided between the distal opening of threading lumen 301 and the distal surface of locking pin 300. The locking pin 300 is made of a biocompatible material such as stainless steel, pure titanium, nickel titanium, cobalt chromium alloy, and preferably pure titanium or stainless steel.
In other embodiments, in order to improve the coupling force between the crimped nail 300 and the suture, at least one pair of interlocking structures may be disposed in the threading cavity 301 of the nail 300, for example, a convex locking platform and a concave locking hole may be disposed at two positions opposite to the threading cavity 301, when the nail 300 is subjected to external crimping force and begins to deform, the convex locking platform is pressed into the concave locking hole, and when the nail 300 continues to deform, the locking platform and the locking hole are simultaneously deformed until they cannot be separated, and at this time, the suture is firmly fixed in the threading cavity 301 of the nail 300.
In order to improve the connecting force between the crimped nail 300 and the suture, an anti-slip structure, such as anti-slip threads or a rough treatment, may be further disposed on the inner circumferential surface of the threading cavity 301, so that after the nail 300 is deformed by external crimping force, the friction between the suture and the inner circumferential surface of the threading cavity 301 is increased, and the suture is more firmly fixed in the threading cavity 301 of the nail 300.
Referring again to fig. 3, in this embodiment, the proximal end of the first collet 22 is rotatably connected to the proximal end of the second collet 24 by a shaft 27, and the shaft 27 defines a through hole 271 that communicates with the threading channel 26. The axis of the rotating shaft 27 coincides with the axis of the hinge between the first chuck 22 and the second chuck 24. Opposite ends of the shaft 27 are connected to the pushing assembly 60. A shaft 27 is fixed to the proximal end of second chuck 24 or first chuck 22, and accordingly, the proximal end of first chuck 22 or second chuck 24 is rotatably coupled to shaft 27.
Referring to fig. 3 and fig. 6, in the present embodiment, the thread cutting element 29 includes a first thread cutting element 291 and a second thread cutting element 293, the first thread cutting element 291 is disposed on a side surface of the first clamping head 22 facing the threading channel 26, and the second thread cutting element 293 is disposed on a side surface of the second clamping head 24 facing the threading channel 26; when the first collet 22 is rotated toward the second collet 24, the first thread cutting member 291 and the second thread cutting member 293 are staggered to cut the thread.
Referring to fig. 6 to 9, the first clamping head 22 includes a first clamping piece 221 and a connecting hook 223 disposed at a middle portion of a proximal end of the first clamping piece 221. The coupling hook 223 is provided with a shaft hole 224 along an axial direction perpendicular to the insertion type remote locking and thread cutting device 100, the rotating shaft 27 is received in the shaft hole 224, and the coupling hook 223 rotates along the rotating shaft 27. The proximal end of the first clamping head 22 is axially provided with a threading hole 225, and the threading hole 225 is communicated with the threading channel 26. In this embodiment, the wire passing hole 225 is opened on the connecting hook 223, and the wire passing hole 225 penetrates through the shaft hole 224 and the gap between the connecting hook 223 and the first clip 221. The side of first jaw 22 facing away from second jaw 24 is provided with a sloped slide guide surface 226, and slide guide surface 226 is located at the distal end of first jaw 22 and extends obliquely towards the side facing away from threading channel 26. Specifically, the thickness of the distal end of the first clip piece 221 is greater than the thickness of the proximal end, a protrusion is formed on the distal end of the first clip piece 221, and the sliding guide surface 226 is connected to the first clip piece 221 and the protrusion. The side of first jaw 22 facing second jaw 24 adjacent the distal end is provided with first clamping teeth 227, first clamping teeth 227 including a plurality of gullets each extending in an axial direction generally parallel to axial bore 224. The distal end of the first clamping head 22 is provided with a spring catch 228, and in this embodiment, the side of the first clamping piece 221 facing the second clamping head 24 is provided with inclined spring catches 228 on two opposite sides of the first clamping teeth 227.
As shown in fig. 8 and 9, the first wire-cutting element 291 is a protruding strip protruding from the first clamping head 22 and facing the side surface of the second clamping head 24, and opposite ends of the protruding strip extend to opposite side surfaces of the first clamping piece 221, i.e. the length of the protruding strip in the axial direction parallel to the shaft hole 224 is greater than the length of the tooth space of the first clamping tooth 227 in the axial direction parallel to the shaft hole 224. The first wire cutting member 291 includes a first wire cutting surface 2911 facing the first jaw 227 and a contact surface 2913 facing the second cartridge 24, the intersection of the first wire cutting surface 2911 and the contact surface 2913 forming a first wire cutting edge 2914, the first wire cutting edge 2914 being for cutting a suture. The first thread cutting edge 2914 extends at an angle to the axial direction of the threading channel, and preferably, the first thread cutting edge 2914 extends in a direction perpendicular to the axial direction of the threading channel, that is, the first thread cutting edge 2914 extends in an axial direction parallel to the shaft hole 224, and the first thread cutting edge 2914 extends for a length longer than the length of the lock pin 300 extended in a direction parallel to the axis of the hinge after being pressed.
Preferably, the first tangential surface 2911 is located on an arc surface with the axis of the hinge between the first chuck 22 and the second chuck 24 as an axis, that is, the first tangential surface 2911 is located on an arc surface with the axis of the shaft hole 224 as an axis. The first wire cutting edge 2914 is located on the first wire cutting surface 2911.
A first avoiding groove 2916 is formed between the first wire cutting element 291 and the first clamping tooth 227 on the side surface of the first clamping piece 221 facing the second clamping head 24, and the first avoiding groove 2916 is used for accommodating the second wire cutting element 293.
As shown in fig. 7, 10 and 11, the second clamping head 24 includes a second clamping piece 241, a second clamping tooth 243 is disposed adjacent to the distal end of the side surface of the second clamping head 24 facing the first clamping head 22, specifically, the second clamping tooth 243 is disposed adjacent to the distal end of the side surface of the second clamping piece 241 facing the first clamping head 22, the second clamping tooth 243 includes a plurality of tooth slots, and each tooth slot of the second clamping tooth 243 extends in the same direction as the tooth slot of the first clamping tooth 227. When the first chuck 22 and the second chuck 24 are rotatably connected by the shaft 27, the first teeth 227 of the first chuck 22 and the second teeth 243 of the second chuck 24 are dislocated and can be engaged with each other, so that the first chuck 22 rotates towards the second chuck 24, and the first teeth 227 and the second teeth 243 can extrude the locking pin 300 placed in the gap 25 into a shape with curvature. The proximal end of the second collet 24 defines a shaft hole 244 along an axial direction parallel to the shaft hole 224, and the shaft 27 is received in the shaft hole 244. Specifically, the axial bore 244 is located adjacent the proximal end of the side of the second jaw 241 facing the first jaw 22. The proximal end of the second jaw 241 facing the side of the first collet 22 defines a receiving slot 246, the proximal end of the receiving slot 246 extends through the proximal end of the second jaw 241, and the receiving slot 246 is configured to receive the coupling hook 223 of the first collet 22. One side of the second clamping piece 241 facing away from the second clamping teeth 243 is provided with a positioning portion 247, and the positioning portion 247 is used for fixing the chuck assembly 20 in the pushing assembly 60.
As shown in fig. 10 and 11, the second thread cutting element 293 is a protruding strip protruding from the second collet 24 and facing the first collet 22, and the length of the protruding strip extending along the axial direction of the axial hole 244 is less than or equal to the width of the receiving groove 246 extending along the axial direction of the axial hole 244. The second thread cutting element 293 comprises a second thread cutting surface 2931 facing away from the second clamping tooth 243 and a contact surface 2933 facing towards the first clamping head 22, wherein the intersection of the second thread cutting surface 2931 and the contact surface 2933 forms a second thread cutting edge 2934, and the second thread cutting edge 2934 is used for cutting the suture thread. An included angle is formed between the extending direction of the second tangent knife edge 2934 and the axial direction of the threading channel; preferably, the second tangential blade 2934 extends in a direction perpendicular to the axial direction of the threading channel, that is, the second tangential blade 2934 extends in an axial direction parallel to the axial hole 244, and the length of the second tangential blade 2934 is longer than the length of the second tangential blade 29300 extending in a direction parallel to the axis of the hinge after being pressed. The intersection of the contact surface 2933 of the second thread cutting member 293 and the side facing the second clamping tooth 243 is radiused to prevent severing of the suture thread. In this embodiment, the intersection of the contact surface 2933 of the second wire cutter 293 and the side facing the second clipping tooth 243 is rounded. The first cutting edge 2914 and the second cutting edge 29344 have an amount of alignment to cut the suture.
Preferably, the second tangential plane 2931 is located on an arc surface with the axis of the hinge between the first chuck 22 and the second chuck 24 as the axis, that is, the second tangential plane 2931 is located on an arc surface with the axis of the shaft hole 244 as the axis. The second tangential cutting edge 2934 is located on the second tangential plane 2931.
The side of the second clip 241 facing the first clip 22 near the proximal end of the second wire cutting element 293 is provided with a second avoiding groove 2936, and the second avoiding groove 2936 is used for receiving the first wire cutting element 291.
As shown in fig. 7, the chuck assembly 20 further includes an elastic member 28, the elastic member 28 is used for rotational restoration of the first chuck 22 so that the locking pin 300 is inserted into the gap 25 between the first chuck 22 and the second chuck 24, and after the first chuck 22 and the second chuck 24 compress the locking pin 300, the first chuck 22 is restored so that the locking pin 300 is smoothly released.
In this embodiment, the elastic element 28 is located between the first chuck 22 and the second chuck 24, and the elastic element 28 is a spring plate, and the spring plate includes a fixing portion 282 located on the second chuck 24 and an elastic portion 284 extending from the fixing portion 282 to the first chuck 22 in an inclined manner. Specifically, the fixing portion 282 is a rectangular plate, two elastic portions 284 are respectively disposed at two opposite ends of one side of the rectangular plate facing away from the rotating shaft 27, and each elastic portion 284 is an arc-shaped plate extending from the rectangular plate toward the first chuck 22 in an inclined manner. One end of the elastic part 284 away from the fixing part 282 is bent toward the second cartridge 24, and one end of the elastic part 284 away from the fixing part 282 is provided with an abutting surface 285 which is in sliding contact with the first cartridge 22, and specifically, the abutting surface 285 is in slidable contact with the corresponding clip groove 228. Preferably, the abutment surface 285 is a curved surface. In this embodiment, the second wire cutter 293 extends along the axial direction of the shaft hole 244 for a length smaller than the interval between the two elastic parts 284 of the elastic member 28.
As shown in fig. 7 to 12, when assembling the cartridge assembly 20, the fixing portion 282 of the elastic member 28 is fixed to the second clip 241 of the second cartridge 24, the connecting hook 223 of the first cartridge 22 is inserted into the receiving groove 246 of the second cartridge 24, the shaft hole 224 of the first cartridge 22 is aligned with the shaft hole 244 of the second cartridge 24, the rotating shaft 27 is inserted into the shaft holes 224 and 244, and the through hole 271 of the rotating shaft 27 faces the wire passing hole 225 of the first cartridge 22. At this time, the elastic member 28 is located between the first chuck 22 and the second chuck 24, the contact surface 285 of the elastic member 28 contacts the clip groove 228 of the first chuck 22, and the through hole 271 communicates with the gap between the first chuck 22 and the second chuck 24. At this time, the first tangent plane 2911 of the first tangent member 291 and the second tangent plane 2931 of the second tangent member 293 are both located on the arc surface with the same radius taking the axis of the hinge between the first chuck 22 and the second chuck 24 as the axis, that is, the first tangent plane 2911 and the second tangent plane 2931 are both located on the arc surface with the same radius taking the axis of the rotating shaft 27 as the axis; the second thread cutting element 293 is located between the two elastic parts 284 of the elastic element 28, the top of the second thread cutting element 293 extends out of the elastic element 28, and the contact surface 2913 of the first thread cutting element 291 is spaced from the contact surface 2933 of the second thread cutting element 293 to facilitate the threading of a suture thread; the first teeth 227 and the second teeth 243 are offset from each other, i.e., the distal surface of the first collet 22 is not coplanar with the distal surface of the second collet 24, and the first tangential surface 2911 of the first collet 22 is coplanar with the second tangential surface 2931 of the second collet 24.
Referring to fig. 13 and 14, when a force is applied to the first chuck 22 to rotate the first chuck 22 along the rotating shaft 27 toward the second chuck 24, that is, the distal end of the first chuck 22 approaches the distal end of the second chuck 24, the elastic element 28 is pressed by the first chuck 24 to be elastically deformed, the contact surface 285 of the elastic element 28 is slidably contacted with the spring slot 228 of the first chuck 22, and the first clamping teeth 227 move toward the second clamping teeth 243 until the first clamping teeth 227 are engaged with the second clamping teeth 243; first tangent line spare 291 and second tangent line spare 293 are crisscross, and is concrete, first tangent line face 2911 and second tangent line face 2931 coincidence have certain coincidence volume between first tangent line sword 2914 and the second tangent line sword 2934 to guarantee can use less dynamics to cut off the stylolite fast, this kind of tangent line mode like the scissors, because two blades have certain coincidence volume during the tangent line, can effectively guarantee that the stylolite is cut off. During the rotation of the first clamping teeth 227 relative to the second clamping teeth 243, the through hole 271 of the rotating shaft 27 and the wire passing hole 225 of the first clamping head 22 are always in a communication state.
In other embodiments, the second chuck 24 is provided with a coupling hook, the first chuck 22 is provided with a receiving groove corresponding to the coupling hook, and the first chuck 22 and the second chuck 24 are rotatably connected through a rotating shaft.
In other embodiments, the fixing portion 282 of the elastic element 28 may be positioned at the first chuck 22, the elastic portion 284 of the elastic element 28 extends obliquely toward the second chuck 24, and the contact surface 285 of the elastic portion 284 is in contact with the second chuck 24 in a sliding manner.
In other embodiments, the elastic element 28 may also be a spring or an elastic block disposed between the first chuck 22 and the pushing assembly 60, and the spring or the elastic block is used for resetting the first chuck 22.
Referring to fig. 15 and 16, the driving assembly 40 includes a pin member 42, a driving member 44 rotatably connected to the proximal end of the pin member 42, and a link pin 45 connected between the pin member 42 and the driving member 44, wherein the threading passage 26 extends through the pin member 42 and the driving member 44. The driving member 44 is rotatably connected to the pushing assembly 60, and the driving member 44 rotates relative to the pushing assembly 60 and moves axially to drive the pin member 42 to slidably push the first chuck 22 axially, so that the first chuck 22 rotates relative to the second chuck 24 around the rotating shaft 27. In this embodiment, the driving member 44 includes a screw 442 and a rotating mandrel 445 axially connected to the screw 442, specifically, a distal end of the rotating mandrel 445 is fixedly connected to the screw 442, a proximal end of the rotating mandrel 445 is fixedly connected to the movable portion 84, and the rotation of the movable portion 84 can drive the rotating mandrel 445 and the screw 442 to rotate together.
As shown in fig. 17 and 18, the push rod member 42 includes a push rod 421 for axially slidably abutting against the guide surface 226 of the first chuck 22, and a connection block 423 disposed at a proximal end of the push rod 421, and the push rod 421 is located at one side of the connection block 423 in the radial direction. The connecting block 423 is provided with a through hole 424 along the axial direction, and the through hole 424 penetrates through the distal end face and the proximal end face of the connecting block 423. The end of the push rod 421 away from the connecting block 423 is provided with an arc-shaped sliding-assistant surface 426, and the sliding-assistant surface 426 is used for slidably contacting the sliding-guiding surface 226. Specifically, one end of the top bar 421 away from the connecting block 423 is convexly provided with an abutting block 425, and the sliding guide surface 226 is arranged on the outer side surface of the abutting block 425. In this embodiment, the connection block 423 is a cylindrical block, the through hole 424 extends along an axial line of the cylindrical block, and an outer side surface of the push rod 421 is coplanar with an outer side surface of the connection block 423.
In other embodiments, the abutting block 425 of the push rod 421 can be omitted, and the sliding guide surface 226 is directly disposed on the distal end surface of the push rod 421.
As shown in fig. 19, the proximal end of the screw 442 is provided with a fixing hole 4420 along the axial center line thereof for fixing the rotating spindle 445, and the distal end of the screw 442 is rotatably connected to the proximal end of the ejector pin member 42 by the link pin 45.
Specifically, the distal end of the screw 442 is provided with a connecting hole 4422 along the axial line thereof, the connecting hole 4422 is communicated with the fixing hole 4420, the aperture of the connecting hole 4422 is smaller than that of the fixing hole 4420, and a step surface 4425 is formed between the connecting hole 4422 of the screw 442 and the fixing hole 4420. The rotating mandrel 445 is a hollow shaft rod, that is, the rotating mandrel 445 is provided with a hollow inner hole 4450 in the axial direction, the distal end of the rotating mandrel 445 is fixed in the fixing hole 4420, and the hollow inner hole 4450 of the rotating mandrel 445 is communicated with the connecting hole 4422.
As shown in fig. 20, the link pin 45 includes a cylindrical pin body 451 and a stopper ring 453 provided on an outer peripheral surface of one end of the pin body 451, an outer diameter of the pin body 451 is slightly smaller than a bore diameter of the connection hole 4422, and an outer diameter of the stopper ring 453 is larger than the bore diameter of the connection hole 4422 and smaller than the bore diameter of the fixing hole 4420. The connecting rod pin 45 is axially provided with a lead hole 455.
Referring to fig. 15-22, in the assembled driving assembly 40, the rotating shaft 445 is fixedly connected to the screw 442, and the rotation of the rotating shaft 445 can drive the screw 442 to rotate; the hollow inner hole 4450 of the rotating spindle 445 and the lead hole 455 of the link pin 45 communicate.
In other embodiments, the proximal end of the pin body 451 of the link pin 45 is fixed to the screw 442, and the distal end of the pin body 451 is rotatably connected to the connection block 423 of the pin member 42, i.e., the distal end of the pin body 451 is rotatably connected to the through hole 424. The distal end of the pin body 451 is provided with a stopper ring 453 stopped at the distal end surface of the connection block 423 to prevent the pin body 451 from being separated from the plunger member 42.
Referring to fig. 22 to 29, the pushing assembly 60 includes a thrust tube 62 rotatably sleeved on the screw 442, a front end outer tube 64 connected to a distal end of the thrust tube 62, a pushing shaft 66 connected to a distal end of the thrust tube 62, and an end cap 67 covering a distal end of the front end outer tube 64. The inner wall of the thrust tube 62 is provided with an internal thread 622 corresponding to the screw 442, the distal end of the pushing shaft 66 is fixedly connected to the proximal end of the thrust tube 62, and the proximal end of the pushing shaft 66 is fixedly connected to the fixing portion 82.
As shown in fig. 22 to 24, a through hole 623 is axially formed in the thrust tube 62, the internal thread 622 is disposed on the inner circumferential surface of the through hole 623, a snap-fit ring groove 624 is formed around the through hole 623 at the proximal end of the thrust tube 62, and the distal end of the pushing shaft 66 is fixedly connected to the snap-fit ring groove 624; the distal end of the thrust tube 62 projects from the periphery of the through hole 623 to a distal end by a snap ring 626, the snap ring 626 is used for fixedly connecting the proximal end of the front end outer tube 64, and the internal thread 622 also passes through the inner circumferential surface of the snap ring 626.
As shown in fig. 25 and 26, the front end outer tube 64 is a hollow tube, i.e., the front end outer tube 64 is axially provided with a through hole 641. A clamping ring groove 644 is formed around the through hole 641 at the near end of the front end outer tube 64, and the clamping ring 626 of the thrust tube 62 is connected to the clamping ring groove 644; the distal end of the front outer tube 64 protrudes distally around the through hole 641 to form a snap ring 646, and the snap ring 646 is used for fixedly connecting the end cap 67. Two opposite shaft holes 647 are formed in the middle of the front end outer tube 64 in the radial direction and used for mounting two opposite ends of the rotating shaft 27.
The pushing shaft 66 is a hollow outer tube, i.e., the pushing shaft 66 is axially provided with a hollow inner cavity 662.
As shown in fig. 27 and 28, the end cap 67 defines a suture entrance 670 corresponding to the void 25, and the locking pin 300 can be inserted into the void 25 through the suture entrance 670. Specifically, the end cap 67 includes a circular cover plate 672 and an annular connecting plate 674 disposed at the periphery of the cover plate 672, the connecting plate 674 is adapted to be sleeved on the snap ring 646 of the front end outer tube 64, and the suture inlet 670 is axially opened at the middle of the cover plate 672. Suture inlet 670 includes a central opening 671 in the middle of cover plate 672 and side slots 673 on opposite sides of central opening 671, each side slot 673 extending in a radial direction, side slots 673 for receiving compressed staple 300. In this embodiment, the central opening 671 is a circular hole, and the width of each side slot 673 is slightly smaller than the diameter of the central opening 671.
Referring to fig. 29 and 30, in assembling the interventional remote suture locking device 100, (1) the thrust tube 62 is sleeved outside the screw 442 such that the internal thread 622 of the thrust tube 62 is screwed with the external thread of the screw 442, and the distal end surface of the screw 442 is flush with the distal end surface of the thrust tube 62 or the distal end surface of the screw 442 extends out of the distal end surface of the thrust tube 62; (2) inserting the pin body 451 of the link pin 45 into the connection hole 4422 through the fixing hole 4420 of the screw 442 such that the pin body 451 is exposed to the distal end surface of the connection hole 4422 until the stopper ring 453 contacts the step surface 4425; (3) inserting the pin body 451 into the through hole 424 of the connecting block 423 and fixing the pin body by laser welding or the like, wherein the distal end surface of the pin body 451 is flush with the distal end surface of the connecting block 423; (4) the far end of the rotating mandrel 445 is fixedly inserted into the fixing hole 4420 of the screw 442, at this time, the ejector rod piece 42 is rotatably connected to the far end of the screw 442 through the connecting rod pin 45, the stop ring 453 prevents the ejector rod piece 42 from being separated from the screw 442, the rotating mandrel 445 is fixedly connected with the screw 442, the rotation of the rotating mandrel 445 can drive the screw 442 to rotate, and the hollow inner hole 4450 of the rotating mandrel 445 is communicated with the lead hole 455 of the connecting rod pin 45; (5) sleeving the pushing shaft 66 outside the rotating mandrel 445, and inserting the distal end of the pushing shaft 66 into the clamping ring groove 624 of the thrust tube 62; (6) the clamping ring 626 of the thrust tube 62 is inserted and fixed into the clamping ring groove 644 of the front end outer tube 64, so that the far end of the thrust tube 62 is fixedly connected to the near end of the front end outer tube 64; (7) fixing the clamp head assembly 20 at the far end inside the front end outer tube 64, specifically, fixing the positioning part 247 of the second clamp head 24 on the inner circumferential surface of the front end outer tube 64, so that the push rod 421 faces the first clamp head 22, that is, the slide-assisting surface 426 on the push rod 421 corresponds to the slide-guiding surface 226 of the first clamp head 22, and the two opposite ends of the rotating shaft 27 are respectively installed inside two shaft holes 647 of the front end outer tube 64; (8) sleeving the connecting plate 674 of the end cover 67 on the clamping ring 646 of the front end outer tube 64, so that the end cover 67 is fixedly connected to the distal end of the front end outer tube 64, and the suture inlet 670 faces the gap 25 between the first chuck 22 and the first chuck 24, at this time, the hollow inner cavity 662 of the pushing shaft 66, the through hole 623 of the thrust tube 62, the through hole 641 of the front end outer tube 64 and the suture inlet 670 of the end cover 67 are axially communicated; (9) the proximal end of the rotating mandrel 445 and the proximal end of the pushing shaft 66 are connected to the movable portion 84 and the fixed portion 82, respectively. At this time, the gap 25, the space between the first and second thread cutting members 291 and 293, the through hole 271, the thread passing hole 225, the through hole 641, the lead hole 455 and the hollow inner hole 4450 are axially communicated with each other, and a thread passing passage 26 for passing a thread is formed.
Referring to fig. 31-36, the use of the interventional remote locking and cutting device 100 of the present invention is described below by taking a valve repair of a mitral valve of a heart as an example.
The mitral valve is a one-way "valve" between the Left Atrium (LA) and the Left Ventricle (LV), which ensures blood flow from the left atrium to the left ventricle. A normal, healthy mitral valve has a plurality of chordae tendineae, and when the left ventricle is in a diastolic state, the leaflets of the mitral valve are in an open state, and blood flows from the left atrium to the left ventricle; when the left ventricle is in a contraction state, the chordae tendineae are stretched, and the valve leaflets are prevented from being flushed to the atrium side by blood flow. As shown in fig. 31, the leaflets of the mitral valve are divided into an anterior leaflet 401 and a posterior leaflet 403, and if the mitral valve is diseased and the left ventricle is in a contracted state, the anterior leaflet 401 and the posterior leaflet 403 cannot return to a closed state as in a normal state, and the impulse of blood further causes the leaflets to fall into the left atrium, which causes blood regurgitation.
The utility model discloses the use of intervention formula remote locking knot and tangent line device 100 in the reason of mitral valve is to reason repair art that the first embodiment provided is as follows:
the first step is as follows: as shown in fig. 31, firstly, after the femoral vein puncture and transseptal puncture of a patient, a plurality of suture lines 500 with elastic gaskets 501 are respectively implanted into the anterior leaflet 401 and the posterior leaflet 403 of the mitral valve, and the point contact between the suture lines 500 and the leaflets is converted into the surface contact between the elastic gaskets 501 and the leaflets, so that the risk of tearing of the leaflets can be effectively reduced;
the second step is that: as shown in fig. 32 and 34, a plurality of sutures 500 on both side leaflets are all threaded into the threading cavity 301 of the locking nail 300 outside the patient, and the proximal ends of the sutures 500 pass through the threading cavity 301 of the locking nail 300 of the interventional remote locking and thread cutting device 100, the gap 25 between the first clamping head 22 and the second clamping head 24, the through hole 271 of the rotating shaft 27, the thread passing hole 225 of the first clamping head 22, the through hole 641 of the front end outer tube 64, the lead hole 455 of the connecting rod pin 45 and the hollow inner hole 4450 of the rotating spindle 445 in sequence and then pass out from the proximal end of the movable part 84;
the third step: as shown in fig. 32 and 35, the distal end of the interventional remote locking and thread cutting device 100 is pushed into the heart through the femoral vein and the interatrial septum by means of a bending sheath (not shown), moving closer to the leaflets of the mitral valve while pulling the suture 500 until the distal end of the interventional remote locking and thread cutting device 100 reaches a predetermined position;
the fourth step: adjusting the tightness of the sutures 500 on the anterior leaflet 401 and the posterior leaflet 403, respectively, while determining by ultrasound the state of minimum mitral regurgitation, when this state is reached, stopping the adjustment, maintaining the tightness of the two sets of sutures 500, i.e. maintaining the relative distance between the anterior leaflet 401 and the posterior leaflet 403 of the mitral valve;
the fifth step: keeping the fixed part 82 of the handle 80 stationary, driving the movable part 84 to rotate towards the far end, at this time, rotating the mandrel 445 to drive the screw 442 to move towards the far end relative to the pushing shaft 66, the screw 442 driving the ejector rod 42 to move towards the far end, the far end of the ejector rod 421 of the ejector rod 42 continuously extruding the first chuck 22, making the first chuck 22 close towards the second chuck 24, pressing and holding the locking nail 300 between the first chuck 22 and the second chuck 24, the elastic part 28 being extruded to generate elastic deformation until the locking nail 300 is deformed, and locking the suture 500 in the locking nail 300 together; meanwhile, when the first chuck 22 and the second chuck 24 gradually get closer together, the first tangent blade 2914 of the first chuck 22 and the second tangent blade 2934 of the second chuck 24 also gradually align, and in the process of deformation of the locking nail 300, the alignment amount between the first tangent blade 2914 and the second tangent blade 2934 gradually increases to cut the suture 500; then, the movable part 84 is driven to move proximally, the push rod 421 releases the compression on the first clamping head 22, the first clamping head 22 is expanded and restored to the initial position under the action of the elastic reset of the elastic element 28, and the deformed locking nail 300 is released from the suture line inlet 670 of the end cover 67;
and a sixth step: as shown in fig. 33 and 36, the distal end of the interventional remote knot and cutting device 100 is withdrawn from the patient and the locking pin 300 remains in the patient, at which point the locking pin 300 secures the two sets of sutures 500 through the anterior leaflet 401 and posterior leaflet 403, respectively, and the anterior leaflet 401 and posterior leaflet 403 of the mitral valve complete an edge-to-edge repair to form a bi-foraminous structure.
It can be understood that, the above-mentioned only uses the path that the remote locking of formula of intervention and tangent line device are used for through femoral vein-interatrial septum-left atrium-mitral valve to carry out the process of intervention's mitral valve repair as an example, has explained the utility model discloses a use, the remote locking of formula of intervention and tangent line device of the utility model also can be used to the locking and the fixed of the stylolite in other operation processes.
The utility model discloses an intervention formula remote locking knot and tangent line device 100 is particularly useful for following scene, if:
(1) performing an interventional mitral valve repair procedure via a femoral artery-aortic arch-aortic valve-left ventricle-mitral valve pathway;
(2) interventional mitral valve repair procedures are performed via the jugular vein-interatrial septum-left atrium-mitral valve approach.
The following scenario applies as well: (1) performing an interventional tricuspid valve repair procedure via the femoral vein-right atrium-tricuspid valve pathway; (2) interventional tricuspid valve repair surgery is performed via the jugular vein-right atrium-tricuspid valve approach. By way of minimally invasive intervention, remotely operating the interventional remote locking knot and cutting device 100 outside the patient's body secures the suture 500 implanted on the leaflets by the locking staples 300.
In other embodiments, the rod member 42 is connected to the front end outer tube 64 by a guide groove and a guide bar extending in the axial direction, so as to ensure that the rod member 42 moves only in the axial direction, but does not rotate, in the through hole 641 of the front end outer tube 64. Specifically, the outer wall of the ejector rod 42 is provided with a guide bar extending in the axial direction, and the inner circumferential surface of the front end outer tube 64 is provided with a guide groove corresponding to the guide bar; or the outer wall of the ejector rod 42 is provided with a guide groove extending along the axial direction, and the inner circumferential surface of the front end outer tube 64 is provided with a guide bar corresponding to the guide groove, and the guide bar can slide along the axial direction in the guide groove.
Referring to fig. 37, the structure of the insertion type remote locking and wire cutting device of the second embodiment of the present invention is similar to that of the first embodiment, except that the wire cutting member of the chuck assembly in the second embodiment is different from that of the first embodiment, and the wire cutting member in the second embodiment only includes one wire cutting member 291 a. Specifically, the tangent 291a is protruded from the side of the first chuck 22 facing the second chuck 24 and is in the shape of a bar, and the extension of the tangent 291a along the axial direction parallel to the rotating shaft 27 is slightly smaller than the gap between the two elastic portions 284 of the elastic member 28. The wire cutting member 291a includes a first wire cutting surface 2911 facing away from the first clamping tooth 227 and a contact surface 2913 facing the second clamping head 24, the intersection of the first wire cutting surface 2911 and the contact surface 2913 forming a first wire cutting edge 2917, the first wire cutting edge 2917 being for cutting a suture. The first cutting edge 2917 extends in an axial direction parallel to the rotation shaft 27. The side of the tangent 291a facing the first gripper tooth 227 and the contact 2913 are rounded, and in particular, the side of the tangent 291a facing the first gripper tooth 227 and the contact 2913 are rounded to prevent the suture from being cut.
Preferably, the first tangential surface 2917 is located on a cambered surface with the axis of the hinge between the first chuck 22 and the second chuck 24 as an axis, that is, the first tangential surface 2917 is located on a cambered surface with the axis of the rotating shaft 27 as an axis. The first wire cutting edge 2917 is located on the first wire cutting surface 2911.
The second collet 24 is provided with a receiving groove 294 instead of the second wire cutting member 293 in the first embodiment. Specifically, the side surface of the second chuck 24 facing the first chuck 22 is provided with a receiving groove 294 corresponding to the wire cutting member 291a, the opening shape of the receiving groove 294 is similar to the shape of the contact surface 2913 of the wire cutting member 291a, the length of the receiving groove 294 extending in the axial direction parallel to the rotating shaft 27 is slightly greater than the length of the wire cutting member 291a extending in the axial direction parallel to the rotating shaft 27, and the width of the receiving groove 294 in the axial direction perpendicular to the rotating shaft 27 is greater than the thickness of the wire cutting member 291a, so that the wire cutting member 291a can be conveniently inserted into the receiving groove 294. The inner side of the receiving groove 294 away from the second clamping tooth 243 is a second tangential surface 2941, the intersection of the second tangential surface 2941 and the side of the second clamping head 24 facing the first clamping head 22 forms a second tangential blade 2944, and when the thread cutting member 291a is inserted into the receiving groove 294, the first tangential blade 2917 and the second tangential blade 2944 are staggered to cut the suture thread. The receiving groove 294 is rounded between the inner side surface adjacent to the second jaw teeth 243 and the side surface of the second jaw 24 facing the first jaw 22 to prevent the cutting of the suture thread
Preferably, the first tangent plane 2917 and the second tangent plane 2941 are located on an arc surface with the axis of the rotating shaft 27 as the axis and the same radius, that is, when the tangent element 291a is inserted into the accommodating groove 294, the first tangent plane 2917 and the second tangent plane 2941 are overlapped, and a certain amount of alignment exists between the first tangent blade 2917 and the second tangent blade 2944, so as to ensure that the suture can be cut quickly with a small force.
The use of the second embodiment for providing an intrusive remote locking and cutting device is the same as the first embodiment, and is not described herein again.
In other embodiments, the side of the tangent 291a facing the first clamping tooth 227 is a first tangent plane, the intersection of which with the contact surface 2913 forms a first tangent edge; the side surface of the receiving groove 294 close to the second clamping tooth 243 is a second tangent plane, and the intersection of the second tangent plane and the side surface of the second clamping head 24 facing the first clamping head 22 forms a second tangent blade edge; the first tangent plane and the second tangent plane are located on an arc surface with the same radius taking the axis of the rotating shaft 27 as the axis. When the thread cutting element 291a is inserted into the accommodating groove 294, the first thread cutting surface and the second thread cutting surface are overlapped, and a certain amount of alignment exists between the first thread cutting edge and the second thread cutting edge, so that the suture thread can be cut off quickly by using small force.
Referring to fig. 38, the structure of the insertion type remote locking and wire cutting device according to the third embodiment of the present invention is similar to that of the first embodiment, except that the wire cutting element of the chuck assembly in the third embodiment is different from that of the first embodiment, specifically, the wire cutting element 293a in the third embodiment is protruded from the side of the second chuck 24 facing the first chuck 22 and is in the shape of a strip, and the extension length of the wire cutting element 293a along the axial direction of the parallel rotating shaft 27 is slightly smaller than the gap between the two elastic portions 284 of the elastic element 28. The wire cutting member 293a includes a first wire cutting surface 2931 facing away from the second clamping tooth 243 and a contact surface 2933 facing toward the first clamping head 22, wherein the intersection of the first wire cutting surface 2931 and the contact surface 2933 forms a first wire cutting edge 2934, and the first wire cutting edge 2934 is used for cutting the suture. The first tangential blade 2934 extends in an axial direction parallel to the rotational shaft 27. The side of the tangent 293a facing the second gripper tooth 243 is rounded at the intersection with the contact surface 2933, and in particular, the side of the tangent 293a facing the second gripper tooth 243 is rounded at the intersection with the contact surface 2933, so as to prevent the suture from being cut.
Preferably, the first tangent plane 2931 is located on an arc surface with the axis of the hinge between the first chuck 22 and the second chuck 24 as an axis, that is, the first tangent plane 2931 is located on an arc surface with the axis of the rotating shaft 27 as an axis. The first wire cutting edge 2934 is located on the wire cutting surface 2931.
The first clip 22 is provided with a receiving groove 295 instead of the first wire-cutting member 291 of the first embodiment. Specifically, the side of the first collet 22 facing the second collet 24 is provided with a receiving groove 295 corresponding to the thread cutting element 293a, the opening shape of the receiving groove 295 is similar to the shape of the contact surface 2933 of the thread cutting element 293a, the length of the receiving groove 295 extending in the axial direction parallel to the rotating shaft 27 is slightly greater than the length of the thread cutting element 293a extending in the axial direction parallel to the rotating shaft 27, and the width of the receiving groove 295 in the axial direction perpendicular to the rotating shaft 27 is greater than the thickness of the thread cutting element 293a, so that the thread cutting element 293a can be conveniently inserted into the receiving groove 295. The inner side of the receiving groove 295 facing away from the first clamping tooth 227 is a second tangential surface 2951, the intersection of the second tangential surface 2951 and the side of the first clamping head 22 facing the second clamping head 24 forms a second tangential blade 2954, and when the thread cutting element 293a is inserted into the receiving groove 295, the first tangential blade 2934 and the second tangential blade 2954 are staggered to cut the suture thread. Receiving groove 295 is radiused between the inner side surface adjacent first gripping tooth 227 and the side surface of first jaw 22 facing second jaw 24 to prevent severing of the suture.
Preferably, the first tangent plane 2931 and the second tangent plane 2951 are located on arc surfaces with the same radius and the axis of the rotating shaft 27 as the axis, that is, when the tangent piece 293a is inserted into the receiving groove 295, the first tangent plane 2931 and the second tangent plane 2951 are overlapped, and a certain amount of alignment is provided between the first tangent blade 2934 and the second tangent blade 2954, so as to ensure that the suture thread can be cut quickly with a small force.
The third embodiment provides the same use process of the intervention type remote locking and cutting device as the first embodiment, and is not repeated herein.
Referring to fig. 39, the structure of the insertion type remote locking and wire cutting device according to the fourth embodiment of the present invention is similar to that of the first embodiment, except that the wire cutting structure of the chuck assembly in the fourth embodiment is slightly different from that of the first embodiment, and the wire cutting structure in the fourth embodiment also includes a first wire cutting element 291b and a second wire cutting element 293 b.
Specifically, the tangent structure in the fourth embodiment includes a first tangent 291b protruding from the side of the first collet 22 facing the second collet 24 and a second tangent 293b protruding from the side of the second collet 24 facing the first collet 22.
The second thread cutting element 293b is shaped like a strip, and the extension length of the second thread cutting element 293b along the axial direction of the parallel rotating shaft 27 is slightly smaller than the gap between the two elastic parts 284 of the elastic element 28. The second thread cutting element 293b includes a second thread cutting surface 2937 facing the second clamping tooth 243 and a contact surface 2933 facing the first clamping head 22, wherein the intersection of the second thread cutting surface 2937 and the contact surface 2933 forms a second thread cutting edge 2938, and the second thread cutting edge 2938 is used for cutting the suture thread.
Preferably, the second tangential plane 2937 is located on an arc surface with the axis of the hinge between the first chuck 22 and the second chuck 24 as an axis, that is, the second tangential plane 2937 is located on an arc surface with the axis of the rotating shaft 27 as an axis. The second tangential cutting edge 2938 is located on the second tangential plane 2937. As the first cartridge 22 is rotated toward the second cartridge 24, the first tangent blade 2916 is interdigitated with the second tangent blade 2937 to sever the suture.
Preferably, the first tangent plane 2911 and the second tangent plane 2937 are located on an arc surface with the same radius and the axis of the rotating shaft 27 as the axis, that is, when the first chuck 22 rotates toward the second chuck 24, the first tangent plane 2911 and the second tangent plane 2937 coincide with each other, and a certain amount of alignment exists between the first tangent blade 2916 and the second tangent blade 2937, so as to ensure that the suture can be cut quickly with a small force.
The use of the intervention remote locking and cutting device of the fourth embodiment is the same as the first embodiment, and is not repeated herein.
Referring to fig. 40-44, the fifth embodiment of the present invention provides an insertion type remote locking and thread cutting device having a structure similar to that of the first embodiment, except that the threading channel 26a of the fifth embodiment is slightly different from that of the first embodiment, and a gap 229 for threading is provided between the proximal end of the first clamping head 22a and the proximal end of the second clamping head 24. That is, the gap 25 between the distal end of the first collet 22a and the distal end of the second collet 24, the space between the contact surface 2913 of the first thread cutting member 291 and the contact surface 2933 of the second thread cutting member 293, the gap 229 between the proximal end of the first collet 22a and the proximal end of the second collet 24, the through hole 641 of the front end outer tube 64, the thread hole 455 of the link pin 45, and the hollow inner hole 4450 of the rotating spindle 445 form the threading passage 26a, and the suture thread 500 is inserted and received in the threading passage 26 a.
Referring to fig. 41, a first chuck 22a of the fifth embodiment is similar to the first embodiment except that: the first cartridge 22a of the fifth embodiment is formed by omitting the wire passing hole 225 from the first cartridge 22 of the first embodiment, and providing a gap 229 between the coupling hook 223 of the first cartridge 22a and the proximal end of the second cartridge 24 of the cartridge assembly after the assembly is completed.
Referring to fig. 42, the rotating shaft 27a of the fifth embodiment is similar to the first embodiment, except that: the rotating shaft 27a of the fifth embodiment is formed by omitting the through-hole 271 from the rotating shaft 27 of the first embodiment.
As shown in fig. 43 and 44, the operation of the intervention remote locking and thread cutting device of the fifth embodiment is similar to that of the first embodiment, except that: in a second step, the proximal end of the suture 500 is threaded out of the proximal end of the movable portion 84 through the distal opening of the staple 300 and the threading lumen 301 of the interventional remote locking and thread cutting device, the gap 25 between the first collet 22a and the second collet 24, the space between the contact surface 2913 of the first thread cutting element 291 and the contact surface 2933 of the second thread cutting element 293, the gap 229 between the proximal end of the first collet 22a and the proximal end of the second collet 24, the through hole 641 of the front outer tube 64, the lead hole 455 of the link pin 45, and the hollow inner hole 4450 of the rotating mandrel 445.
The utility model discloses a first chuck 22a in the fifth embodiment need not process line hole 225, and pivot 27a does not need processing through-hole 271, has not only reduced pivot 27 a's the assembly degree of difficulty, improves production efficiency, and practices thrift manufacturing cost and processing cost.
Referring to fig. 45 to 50, a sixth embodiment of the present invention provides an intrusive remote locking and wire cutting device, which has a structure similar to that of the first embodiment, except that the structures of the screw 442a, the thrust tube 62a and the pin 42a in the sixth embodiment are different from those of the first embodiment, as follows:
the driving member 44 of the intrusive remote locking and thread cutting device in the sixth embodiment also includes a screw 442a and a rotating mandrel 445 axially connected to the proximal end of the screw 442a, the pin 42a is provided with a through hole along the axial line of the screw 442a, the inner surface of the through hole is provided with an internal thread 428 corresponding to the screw 442a, the screw 442a is driven to rotate by the rotation of the rotating mandrel 445, and the pin 42a is driven to move axially by the rotation of the screw 442 a.
As shown in fig. 46 and 47, the screw 442a is a hollow screw rod, that is, the screw 442a is provided with a threading hole 4426 along the axial line thereof, and the threading hole 4426 is used for threading a suture. The outer wall of the proximal end of the screw shaft 442a is provided with a rotating ring 4427 in a radial direction, the proximal end face of the screw shaft 442a is provided with a fixed cylinder 4428 protruding from the circumference of the threading hole 4426 in the axial direction of the screw shaft 442a toward the proximal end, and the outer diameter of the fixed cylinder 4428 is larger than the outer diameter of the screw shaft 442a and smaller than the outer diameter of the rotating ring 4427. The fixed cylinder 4428 is axially provided with a fixed hole 4429 communicated with the threading hole 4426, and the inner diameter of the fixed hole 4429 is larger than that of the threading hole 4426.
As shown in fig. 48, the pin member 42a of the sixth embodiment is added with at least one sliding guide plate 427 and an internal thread 428 corresponding to the external thread of the screw 442a on the inner circumferential surface of the through hole 424 in addition to the first embodiment. Specifically, at least one guide sliding plate 427 is disposed at the distal end of the connecting block 423 and extends along the length direction of the push rod 421, the inner surface of the front end outer tube 64 is provided with a guide sliding groove 648 (as shown in fig. 50) corresponding to the guide sliding plate 427, and the guide sliding plate 427 is slidably inserted into the guide sliding groove 648, so as to prevent the push rod 42a from rotating in the front end outer tube 64.
As shown in fig. 45, the thrust tube 62a of the sixth embodiment omits the internal thread 622 from the thrust tube 62 of the first embodiment, and the fixed cylinder 4428 of the screw 442a is rotatably accommodated in the through hole 623 of the thrust tube 62. A retaining ring 649 is provided radially protruding from the inner circumferential surface of the through hole 641 of the front end outer tube 64 near the proximal end.
In assembling the interventional remote suture locking device of the sixth embodiment, the distal end of screw 442a is inserted into through hole 641 from the proximal end of forward outer tube 64 until rotating ring 4427 of screw 442a abuts retaining ring 649; inserting the connecting block 423 of the ejector pin member 42a into the through hole 641 from the distal end of the front end outer tube 64, screwing the external thread of the screw 442a to the internal thread 428 of the connecting block 423 until the proximal end face of the ejector pin member 42a contacts the retaining ring 649, and the sliding guide plate 427 is slidably inserted into the sliding guide groove 648; then, according to the assembly process of the first embodiment, the collet assembly 20 is fixed at the distal end inside the front end outer tube 64, the connecting plate 674 of the end cover 67 is sleeved on the clamping ring 646 of the front end outer tube 64, the distal end of the thrust tube 62a is fixedly connected to the proximal end of the front end outer tube 64, the distal end surface of the thrust tube 62a contacts the rotating ring 4427, the fixed cylinder 4428 is rotatably accommodated inside the through hole 623, and the distal end surface of the thrust tube 62a and the positioning ring 649 limit the rotating ring 4427 to move axially; the far end of the rotating mandrel 445 is fixedly inserted into the fixed cylinder 4428; sleeving the pushing shaft 66 outside the rotating mandrel 445, wherein the distal end of the pushing shaft 66 is fixed at the proximal end of the thrust tube 62; the proximal ends of the thrust tube 62 and the pushing shaft 66 are fixedly connected to the movable portion 84 and the fixed portion 82, respectively. At this time, the gap 25, the space between the contact surface 2913 of the first thread cutting member 291 and the contact surface 2933 of the second thread cutting member 293, the through hole 271, the thread passing hole 225, the through hole 641, the thread passing hole 4426 and the hollow inner hole 4450 are axially communicated with each other, and a thread passing channel 26 is formed; the rotation of the movable portion 84 can drive the screw rod 442a to rotate, and since the top rod 42a is screwed to the screw rod 442a and the sliding guide plate 427 and the sliding guide groove 648 limit the rotation of the top rod 42a, the rotation of the screw rod 442a drives the top rod 42a to move axially, so that the top rod 421 slidably presses against the first chuck 22.
Referring to fig. 49 and 50, the operation of the intervention type remote locking and cutting device of the sixth embodiment is similar to that of the first embodiment, except that: in a second step, the proximal end of the suture 500 is passed out of the gap 25 between the first collet 22 and the second collet 24, through the space between the first tangent 291 and the second tangent 293, and into the through hole 271 of the shaft 27.
In the fifth step, the fixed portion 82 of the handle 80 is kept still, the movable portion 84 is driven to rotate, at this time, the rotating mandrel 445 drives the screw rod 442a to rotate relative to the front end outer tube 64, the rotation of the screw rod 442a drives the ejector rod 42a to move towards the distal end, the distal end of the ejector rod 421 of the ejector rod 42a continuously presses the first chuck 22, so that the first chuck 22 approaches towards the second chuck 24, the first cutting edge 2914 of the first chuck 22 and the second cutting edge 2934 of the second chuck 24 are gradually abutted, the locking nail 300 between the first chuck 22 and the second chuck 24 is pressed, and the elastic member 28 is pressed to be elastically deformed until the locking nail 300 is deformed, so as to lock the suture 500 in the locking nail 300 together; during the deformation of the locking nail 300, the amount of apposition between the first tangential blade 2914 and the second tangential blade 2934 gradually increases to cut the suture 500; then, the rotating movable portion 84 is driven to rotate to drive the rotating mandrel 445 and the screw rod 442a, so that the push rod member 42a rotates towards the proximal end to release the extrusion of the push rod 421 to the first clamping head 22, the first clamping head 22 is opened and restored to the initial position under the elastic reset action of the elastic member 28, and the deformed locking nail 300 is released from the suture line inlet 670 of the end cap 67.
The above is an implementation manner of the embodiments of the present invention, and it should be noted that, for those skilled in the art, a plurality of improvements and decorations can be made without departing from the principles of the embodiments of the present invention, and these improvements and decorations are also considered as the protection scope of the present invention.
Claims (22)
1. The utility model provides an intervention formula long-range knot and tangent line device for the knot of stylolite and lock nail, a serial communication port, intervention formula long-range knot and tangent line device includes cartridge spare, the distal end of cartridge spare is equipped with and is used for placing the space of stylolite, the lock nail is equipped with the threading chamber along the axial, the threading passageway is seted up along the axial to the cartridge spare of intervention formula long-range knot and tangent line device, the stylolite is worn to locate the threading chamber of stylolite reaches the threading passageway, be equipped with an at least orientation in the cartridge spare the tangent line spare of threading passageway, the cartridge spare extrusion the lock nail makes the lock nail warp with fixed stylolite, tangent line spare cutting the stylolite.
2. The interventional remote knot-and-thread cutting device of claim 1, wherein the jaw assembly comprises a first jaw and a second jaw hinged or integrally formed to each other, a junction of the first jaw and the second jaw communicating with the threading channel.
3. The interventional remote knot and line cutting device of claim 2, wherein the line cutting member comprises a line cutting blade for cutting the suture line, the line cutting blade being located on a cambered surface with an axis of a hinge axis between the first collet and the second collet.
4. The interventional remote locking and thread cutting device according to claim 3, wherein the thread cutting element is provided protruding from a side of the first jaw and/or the second jaw facing the threading channel, and the extension direction of the thread cutting blade forms an angle with the axial direction of the threading channel.
5. The intrusive remote locking and cutting device of claim 4, wherein the cutting edge extends in a direction parallel to the hinge axis, the cutting edge extending for a length greater than a length of the locking pin after being squeezed extending in a direction parallel to the hinge axis.
6. The interventional remote knot and thread cutting device of claim 4, wherein the thread cutting element comprises a first thread cutting element disposed on a side of the first collet facing the threading channel, the first thread cutting element comprising a first thread cutting blade.
7. The interventional remote knot and thread cutting device of claim 6, wherein the thread cutting element further comprises a second thread cutting element disposed on a side of the second collet facing the threading channel, the second thread cutting element comprising a second thread cutting blade.
8. The interventional remote knot and thread cutting device of claim 7, wherein the second thread cutting edge and the first thread cutting edge have an amount of alignment therebetween that severs the suture thread; when the first chuck and the second chuck rotate, the first tangent piece and the second tangent piece are staggered, and the second tangent blade is tangent to the first tangent blade so as to cut off the suture.
9. The interventional remote knot and line cutting device of claim 8, wherein the first line cutting element comprises a first line cutting surface, the second line cutting element comprises a second line cutting surface, the first line cutting blade is positioned on the first line cutting surface, the second line cutting blade is positioned on the second line cutting surface, and the first line cutting surface and the second line cutting surface coincide when the first line cutting element and the second line cutting element are misaligned.
10. The interventional remote knot and thread cutting device of claim 9, wherein the first thread cutting surface and the second thread cutting surface are both located on a cambered surface of the same radius with a hinge axis between the first collet and the second collet as an axis.
11. The interventional remote knot and wire cutting device of claim 9, wherein the first wire cutting element further comprises a contact surface facing the second collet, an intersection of the first wire cutting surface and the contact surface forming the first wire cutting edge; the second wire cutting element further comprises a contact surface facing the first chuck, and the intersection of the second wire cutting surface and the contact surface forms the second wire cutting edge.
12. The interventional remote knot-and-thread cutting device of claim 7, wherein a side of the second collet facing the first collet defines a receiving slot corresponding to the first thread cutting element, the receiving slot including the second thread cutting edge, the first and second thread cutting edges being tangent to sever the thread when the thread cutting element is inserted into the receiving slot.
13. The interventional remote knot and thread cutting device of claim 12, wherein the first thread cutting element comprises a first thread cutting surface proximate the proximal end and a contact surface facing the second collet, an intersection of the first thread cutting surface and the contact surface forming the first thread cutting edge; the accommodating groove comprises a second tangent plane tangent to the first tangent plane, and a second tangent blade is formed at the intersection of the second tangent plane and the side surface of the second chuck facing the first chuck.
14. The interventional remote knot and thread cutting device of claim 13, wherein the first thread cutting surface and the second thread cutting surface are both located on a cambered surface of the same radius with a hinge axis between the first collet and the second collet as an axis.
15. The interventional remote knot and thread cutting device of claim 3, wherein the proximal end of the first chuck is rotatably connected with the proximal end of the second chuck through a rotating shaft, the rotating shaft is provided with a through hole communicated with the threading channel, and the axis of the rotating shaft coincides with the hinge axis.
16. The interventional remote knot and thread cutting device of claim 2, wherein a side of the first collet facing the second collet is provided adjacent the distal end with first gripping teeth, a side of the second collet facing the first collet is provided adjacent the distal end with second gripping teeth, the first gripping teeth and the second gripping teeth are misaligned and intermeshed, the first and second gripping teeth extruding a locking pin placed within the void into a shape having a curvature.
17. The interventional remote knot and wire cutting device of claim 16, wherein the wire cutting element is disposed proximate to a proximal end of the first gripping tooth or the second gripping tooth.
18. The interventional remote knot and thread cutting device of claim 2, wherein the collet assembly further comprises an elastic member for rotational return of the first collet, the elastic member comprising a fixed portion positioned at the second collet and two spaced elastic portions extending obliquely from the fixed portion to the first collet, an abutment surface slidably contacting the first collet being provided at an end of each elastic portion remote from the fixed portion.
19. The interventional remote knot and thread cutting device of claim 2, wherein the proximal end of the first collet and/or the proximal end of the second collet is axially provided with a thread passing hole, and the thread passing hole is communicated with the threading channel.
20. The interventional remote knot and thread cutting device of claim 2, wherein a gap is provided between the proximal end of the first collet and the proximal end of the second collet, the gap communicating with the threading channel, the suture thread being threaded through the gap.
21. The interventional remote knot and thread cutting device of claim 1, further comprising a drive assembly disposed at a proximal end of the cartridge assembly, the threading channel extending through the drive assembly.
22. The interventional remote knot and thread cutting device of claim 21, further comprising a pushing assembly sleeved outside the collet assembly and the driving assembly, wherein the driving assembly comprises a pin member and a driving member rotatably connected to a proximal end of the pin member, the driving member is rotatably connected to the pushing assembly, and the driving member rotates relative to the pushing assembly to drive the pin member to slidably push the collet assembly to rotate in an axial direction to extrude the locking pin.
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CN201921077796.5U CN211723286U (en) | 2019-07-10 | 2019-07-10 | Intervention type remote locking and cutting device |
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Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN112206022A (en) * | 2019-07-10 | 2021-01-12 | 杭州德晋医疗科技有限公司 | Intervention type remote locking and cutting device |
CN116421243A (en) * | 2023-06-15 | 2023-07-14 | 杭州锐健马斯汀医疗器材有限公司 | Medical cutter |
-
2019
- 2019-07-10 CN CN201921077796.5U patent/CN211723286U/en active Active
Cited By (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN112206022A (en) * | 2019-07-10 | 2021-01-12 | 杭州德晋医疗科技有限公司 | Intervention type remote locking and cutting device |
CN112206022B (en) * | 2019-07-10 | 2024-07-02 | 杭州德晋医疗科技有限公司 | Intervention type remote locking and thread cutting device |
CN116421243A (en) * | 2023-06-15 | 2023-07-14 | 杭州锐健马斯汀医疗器材有限公司 | Medical cutter |
CN116421243B (en) * | 2023-06-15 | 2023-09-12 | 杭州锐健马斯汀医疗器材有限公司 | medical cutter |
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